Comparative study of intrathecal tramadol Administration on postoperative analgesia after transurethral resection of prostate using three different doses of tramadol.

Objectives: 1: To determine the optimal dose requirements of intrathecal Tramadol as the main postoperative Analgesic.2: To evaluate the side effect profile of various doses of Intrathecal Tramadol Study Design & Setting: Prospective Double Blind, Hospital based Study. Materials & Methods: 87 patients of status ASA I and II, aged between 50-70 years scheduled for TURP under spinal anesthesia, received 30 mg, (Group I), 40mg (Group II), and 50mg (Group III) of intrathecal tramadol hydrochloride with 2.5ml of 0.5% bupivacaine each. VAS score was assessed hourly for the first 8 hours after operation and every four hourly thereafter for a total of 24 hours. The duration of analgesia in three groups was obtained from the completion of spinal injection to the time of rescue analgesic administered on demand or when visual analogue score was =3 Results: There was a statistically significant difference in postoperative pain relief in group I (14.69±5.85 hours), group II (18.48±6.18 hours) and group III (19.45±4.626 hours). Incidence of vomiting in group III (34.5%), group II (17.2%) and group I (13.8%) was statistically significant. The Postoperative Visual Analogue Scale score is statistically significant among the three groups at different time periods. Conclusions: Tramadol hydrochloride is an effective analgesic agent when administered intrathecally for postoperative pain.40 mg is an optimum dose for postoperative analgesia given intrathecally without significant increase in side effects.50 mg of tramadol can be used with appropriate anti-emetics to reduce the incidence of nausea and vomiting associated with this dose